Epstein-Barr Virus (EBV), DNA Probe

The Epstein-Barr Virus (EBV), DNA Probe test detects EBV DNA in clinical material by real-time PCR and localizes EBV-encoded nucleic acids in tissue sections by in situ hybridization as an adjunct to histopathology. These complementary approaches are used to establish EBV infection and to evaluate EBV-related pathology. Clinical applications include diagnosis of infectious mononucleosis, assistance with distinguishing EBV from other herpesvirus infections and from exudative tonsillopharyngitis of alternative etiologies, and detection of EBV reactivation in immunocompromised and transplant recipients. Synonyms used in practice include EBV DNA testing and EBV in situ hybridization.

Epstein-Barr virus is a ubiquitous human herpesvirus that replicates predominantly in B lymphocytes and can also infect T lymphocytes and epithelial cells. Transmission typically occurs via respiratory secretions. Primary infection often arises in childhood and is asymptomatic or mild, whereas adolescents and adults more commonly present with infectious mononucleosis characterized by fever, lymphadenopathy, tonsillopharyngitis, and hepatosplenomegaly. Reported complications include hepatitis, pneumonia, hemolytic anemia, thrombocytopenia, aplastic anemia, splenic rupture, myocarditis, and neurologic disease such as Guillain–Barré syndrome, encephalitis, and meningitis. In rare cases, chronic active EBV persists beyond six months with organ involvement and high EBV-specific antibody titers. Following primary infection, EBV establishes lifelong latency in memory B cells and may reactivate with immunodeficiency or iatrogenic immunosuppression, contributing to lymphoproliferative disorders and nasopharyngeal carcinoma. Nucleic acid–based detection employs in situ hybridization to visualize EBV-encoded sequences in tissue or PCR to amplify EBV genomic targets from clinical specimens. Failure to identify target DNA can reflect improper sampling, handling, or fixative, or target copy number below the assay’s analytical sensitivity.